GENERAL SUMMARY OF POSITION:
Under the general supervision of the Operations and Training Specialist or designee, this position is responsible for coordinating client appointments for Consultative Examinations (CE) by medical and psychiatric providers within the Commonwealth of Massachusetts. This position performs complex and varied duties associated with the coordination of departmental administrative functions through the use of the DEScovery computer system as well as Word, Excel, Access and Outlook applications. The Provider Management Coordinator is the primary contact for the community-based DES provider network, interfacing between disability reviewers requesting examinations and the CE network provider performing examinations. This position makes complex decisions regarding protected healthcare information (PHI) based on the Federal regulations regarding the protection of health information under the Health Information Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.
In addition, this position conducts business across all departments within DES. The Provider Management Coordinator is responsible for all functions involving providers for the DES CE provider panel, comprised of approximately 150 clinicians located throughout the Commonwealth of Massachusetts. Decisions made in this area directly impact the timeline for the disability review process and for the determination of benefits for MassHealth and other agency applicants. This position is the primary hub for all coordination of medical and psychiatric examinations, and interacts with clients, providers, and DES staff regarding establishing client appointments.